Should we continue to honor Dr. J. Marion Sims with a Central Park statue?

The statue stuck on a quiet northern section of Central Park wall betrays little of the controversy behind its standing. The figure honors 19th century doctor J. Marion Sims, considered the father of modern gynecology. The controversy is over his early patients’ identities: they were slaves suffering from painful fistulas. Sims eventually cured them, after years of experimentation.

The Sims statue, which has long been criticized by members of the East Harlem community, is receiving renewed scrutiny as Confederate memorials are being toppled and defended with equal fervor. But Sims is far less well-known than Robert E. Lee or Stonewall Jackson, and the case of his memorial provokes more complicated questions about American history and the way that history is remembered today.

A defender of Sims

There’s no question that Sims, who practiced on enslaved women in Alabama, developed a procedure that has had an enormous impact around the world up through today. It cured vesico-vaginal fistulas, a condition that comes from complications in childbirth and results in holes between the bladder and vagina.

Here is an 1857 description of a patient with the condition: Urine “trickles constantly down her thighs . . . keeps her clothing constantly soaked, and exhales without cessation its peculiar odour.”

The seriousness of the condition led to “desperate patients returning again and again, begging that another attempt be made to give them some relief,” writes L. Lewis Wall, a professor of medical anthropology at Washington University in St. Louis School of Medicine. He says that tracks with his experience treating the condition where it still exists in parts of Africa and Asia.

One common charge against Sims is that he conducted his early operations without the use of anesthesia. Wall defends him by saying this is an example of modern observers placing ahistorical expectations on a historical figure. Anesthesia had just been invented as Sims began his work. It didn’t become commonly used for decades, and putting the women under would have been as much of an “experimentation” as the path to a fistula cure for which Sims later became famous.

And that work was less twisted-mad-scientist experimentation than a “direct attempt” to benefit patients with “terrible problems,” says Wall.

A fuller picture

Some historians struggle to reconcile the benefits that have come from Sims’ surgeries with the lack of agency of his patients.

“How do we make an assessment about a historical figure who, ultimately through the usage of exploitative practices, helps women?” asks Deirdre Cooper Owens, a history professor at Queens College who specializes in African-American history, slavery, gender, and medicine and has a forthcoming book about the origins of American gynecology.

Cooper Owens tries to place Sims in his time to see where he is worthy of criticism. On that front, she notes that even Sims’ white peers may have been disturbed by his experiments, as alluded to obliquely in his autobiography.

In other areas, he was commonly deficient. Was he racist? His writings include slurs and the “Southern paternalism that was endemic of nearly every white man who lived during the time,” she writes.

Was it unusual to experiment on slaves? Not especially, to the point that other successful medical breakthroughs such as perfection of the caesarean section also relied on enslaved patients.

So Sims may have been in part acting within the bounds of his time, but that just opens a wider indictment of Sims’ society, a society that has become our own.

What Sims means today

In recent weeks, virtually every politician with a toe near the statue’s district has jumped at the opportunity to call for its removal. It will surely be on the list of statues reviewed by Mayor Bill de Blasio’s “commission” on hate symbols in New York City, details about which will be available “in the coming days,” says a spokeswoman. De Blasio’s wife, Chirlane McCray, has already said on Twitter that the statue should go.

For Cooper Owens, the more pressing concern is the legacy of Sims’ time that is still with us, such as the belief in racial differences in pain tolerance, which has led even recently to African-American patients getting undertreated for pain, according to a 2016 University of Virginia study. The history of slavery and discrimination, and the particular history of medical treatment of black bodies, is still being reckoned with in various ways. That’s the shadow behind Sims’ statue.